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Doctor insights on:
Babinski Maneuver

1

Anything :
That decreases venous return leads to a reduction in volume to the heart. These changes will effect the intensity of murmurs. With the valsalva there ia a transient/ brief increase in output. The straining portion decreases venous return and will increase the intensity of the murmur.Heart rate will also increase. Standing abruptly will do the same.
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3

Lhermitte's sign:
is also called barber's chair sign. The electrical sensation can be quite alarming indeed. A more common cause of this in a 41 year old lady would be a demyelinating disorder
like MS or Clinically Isolated Syndrome. Other localizing signs and symptoms will help with deciding how to proceed in the work (MRI of a portion of the spinal cord, brain or both). Other cord issues need to be excluded.
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4

Babinski sign:
The babinski sign is an indicator of something affecting the motor system in the brain or spinal cord. Therefore, there is no cure or treatment for a babinski sign, per se, the issue is the condition that is causing the sign. A babinski sign could be permanent in the case of a stroke, or could improve if there was pressure on the brain or spinal cord that was treated.
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5

Slow foot reflex:
Suggests possible nervecompression in lumbar or sacral spine, which could result from bulging/ruptured disc, bone spur compressing spinal cord or nerve root, or spinal stenosis. Suggest seeing orthopedic or neurosurgeon for evaluation, tests (including mri), options for treatment. If u have foot drop or similar problems, do not delay. Sooner the treatment, less damage.
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7

Dr ordered MRI:
What is your question? Is your question why the doctor ordered an MRI? Please state the reason the doctor gave for ordering an MRI, and also, an MRI of what? Brain? Heart? Left foot? If you did not ask the doctor the reason, please state why not.
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8

No:
An epley maneuver is only a benefit in benign positional vertigo. In this condition loose calcium deposits are repositioned into an area where they cannot float freely. This is the only condition in which an epley maneuver is a benefit.
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9

Broad ddx:
There may be a bilateral cortical/subcortical brain disruption and MRI could help identify a potential cause based on the pattern of abnormalities. For ex: adult-onset leukodystrophy would show extensive demyelination of the white matter sparing the periventricular white matter vs MS vs Cerebral Autosomal-Dominant Arteriopathy, and work-up is different for each disease.
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10

Involuntary mvmts:
There are some causes that have not been addressed, but the first two could be due to a psychological cause. Expect some kind of follow up evaluation and continued discussion to help close the case on these.
Tingling in the left hand fingers probably is due to something different, such as mild ulnar nervecompression.
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11

Postop complication:
One has to worry about a delayed postoperative complication-significant!!!! Need to see operating surgeon . Potential causes would be hematoma(blood) compressing spinal cord or even a spinal cord lesion remote from operative site
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13

Brakes are released:
The quick answer: the brain/spinal cord send electrical fibers to control the muscles. When the fibers are severed, the muscles "do their own thing", unregulated.
http://www.livestrong.com/article/197920-causes-of-clonus/.
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14

Extensor respons:
The presence of a Babinski sign suggests an upper motor neuron lesion, although in infants the presence of the dorsiflexion of the great toe with plantar stimulation can be normal. Simplifying, it's thought by some it may be related to the difference between the anatomical flexors behaving differently, more as extensors. Medicine Decoded has a reasonable explanation of this.
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15

Comments:
Downbeat nystagmus is a sign of cerebellar/ brainstem connection pathology, and may or may not relate to an effect of the Chiari malformation. This needs further evaluation by a neuro-ophthalmologist, and perhaps a neurosurgeon who has prior EXPERTISE in Chiari, as can be associated with other problems.
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16

Hydrocephalus:
External hydrocephalus is a build up of cerebrospinal fluid over the surface of the brain rather than in the ventricles. Normally cerebrospinal fluid circulates from the brain to the spinal cord and back to the brain. When there is poor reabsorption or blockage then hydrocephalus (water on the brain) develops. See a neurosurgeon to help with treatment.
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17

Not likely:
Benign paroxysmal positional vertigo will not be affected by the pressure changes induced by flying. What induces bppv is any rapid change in posture and position.
The treatment for bppv is the canal repositioning maneuver. Your ENT or neurologist can perform this maneuver for you. Good luck and well wishes.
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